How much rates vary
Facilitymedian $229 · 10th to 90th $81 to $1,862Professionalmedian $186 · 10th to 90th $129 to $309
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $95.50 Median $1,000.00 Typical High $7,943.28 | Facility | None | $95.50 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $134.90 | Professional | None | $95.50 | $95.50 | $134.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $309.03 | Professional | None | $131.83 | $208.93 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $1,995.26 | Facility | None | $478.63 | $645.65 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $208.93 | Professional | None | $128.82 | $138.04 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $154.88 | Facility | None | $95.50 | $95.50 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $147.91 | Professional | None | $93.33 | $147.91 | $147.91 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $199.53 | Professional | None | $95.50 | $123.03 | $199.53 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | 52 · Reduced service | $47.86 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $19.50 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $72.44 Typical High $89.13 | Professional | 54 · Surgery only | $72.44 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $17.78 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $12.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $74.13 Typical High $74.13 | Professional | 51 · Multiple procedures | $45.71 | $74.13 | $74.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.62 Median $29.51 Typical High $29.51 | Professional | 80 · Assistant surgeon | $18.62 | $29.51 | $29.51 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.88 Median $20.89 Typical High $20.89 | Professional | 81 · Minimal assistant surgeon | $12.88 | $20.89 | $20.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.88 Median $20.89 Typical High $20.89 | Professional | 82 · Assistant surgeon, no resident | $12.88 | $20.89 | $20.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.88 Median $20.89 Typical High $20.89 | Professional | AS · PA/NP assist | $12.88 | $20.89 | $20.89 |
Where North Carolina sits
The same service costs 4.0 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Carolina· 8th of 51
$186
AK $372FL $93.33
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.